| Objective:This study uses Meta-analysis to systematically evaluate the clinical efficacy and safety of Tongqiao Huoxue Decoction in the treatment of ischemic stroke,providing an effective evidence for the clinical treatment of ischemic stroke.Methods:Different search strategies were formulated according to the search terms,and all randomized controlled clinical trials related to Tongqiao Huoxue Decoction for the treatment of ischemic stroke published before December31,2022 were collected by searching various databases such as CNKI,Wanfang,VIP,CBM,Pub Med,Web of science,and Cochrane Library.The literature screening was independently completed by two evaluators accordings to established inclusion and exclusion criteria.If there was a dispute,it was referred to a third evaluator for arbitration.Then independently carried out data extraction and literature quality evaluation.Rev Man5.3software was used to measure the total clinical effective rate,neurological defect score,daily living ability index,TCM symptom efficacy,plasma viscosity,fibrinogen,blood lipids(total cholesterol,low-density lipoprotein cholesterol),hypersensitivity C-reactive protein,adverse reactions and other outcomes.To compare the efficacy and safety.Results:1.A total of 25 literatures were included for research,all with a total of2091 patients,1046 patients in the experimental group and 1045 patients in the control group.2.Meta-analysis:(1)A total of 16 literatures observed the total clinical effective rate,indicating that the total clinical effective rate of experimental group in the treatment of ischemic stroke was higher than that in the control group(RR=1.21[1.16,1.26],P<0.05);(2)A total of 16 literatures analyzed the neurological defect score.The results showed that compared with the control group,patients in the experimental group had a significant improvement in the degree of neurological defect(MD=-3.48[-4.47,-2.49],P<0.05);(3)A total of 10 literatures observed the daily living ability index,and the results indicted that the experimental group could more effectively improve the daily living ability of patients(MD=8.44[5.52,11.35],P<0.05);(4)A total of 3literatures observed the efficacy of TCM symptoms,and the results showed that the efficacy of TCM symptoms in the experimental group was significantly better than that of the control group(RR=1.18[1.07,1.31],P<0.05);(5)A total of 3 literatures compared plasma viscosity after treatment,and the results showed that the reduction of plasma viscosity of patients with ischemic stroke in the experimental group was higher than that of the control group(MD=-0.69 [-0.76,-0.63],P<0.05);(6)A total of 7 literatures observed fibrinogen,and the results showed that the effect of reducing fibrinogen in the experimental group was higher than that in the control group(MD=-0.96[-1.37,-0.55],P<0.05);(7)A total of 4 literatures observed total cholesterol after treatment,indicating that the total cholesterol level of patients in the experimental group decreased by a greater extent than that in the control group(MD=-0.54,95%CI[-0.65,-0.43],P<0.05);A total of 3 literatures observed LDL-C after treatment,and the results showed that there was a significant difference between the lower level of the experimental group andthat of the control group(MD=-0.22[-0.30,-0.14],P < 0.05);(8)A total of 7literatures observed hs-CRP.The results showed that a significant decrease in the level of hypersensitivity C-reactive protein in the experimental group compared with the control group(MD=-1.50 [-2.25,-0.76],P<0.05);(9)A total of 13 literatures evaluated adverse reactions.Among them,6 literatures reported the incidence of adverse reactions in both the experimental group and the control group was 0,and 7 literatures reported the occurrence of adverse reactions.The results showed that there was no statistical difference in safety compared the experimental group with the control group in the treatment of ischemic stroke(RR=1.13[0.65,1.96],P>0.05).Conclusion:Meta-analysis shows that the treatment of ischemic stroke with Tongqiao Huoxue Decoction on the basis of conventional Western medicine treatment can significantly improve the total clinical effective rate,reduce the degree of neurological dysfunction,improve their daily living ability and the efficacy of TCM symptoms;And it can significantly reduce plasma viscosity,fibrinogen,blood lipids and hypersensitivity C-reactive protein levels;The safety is good and it is recommended clinically. |
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